The concept of frailty in elderly adults has been gaining acceptance as an emerging geriatric syndrome. Although frailty is a recognizable and common phenomenon in aging, it can be a concept that is difficult to accurately define and diagnose. Frailty is a multi-factorial condition, influenced by the combination of a person's physical, psychological, and social health. Frailty has been shown to have a predictive association with important health outcomes such as first fall, first hospitalization, worsening ADL disability, worsening mobility disability, and death.
Accurate assessment of a patient's frailty level could allow for effective multi-factorial intervention. Frailty has previously been assessed using subjective clinical judgment. More recently, validated clinical scales, such as the Fried frailty index, has been used to quantify frailty levels. The Fried frailty index ranges from 0 to 5. A value of 0 is assigned to individuals considered robust. A value of 1-2 is assigned to individuals considered pre-frail, and a value of 3-5 is assigned to individuals considered frail. Assessing an individual's Fried frailty index requires, however, statistical expertise and a reference sample. The assessment further requires recognition of unintentional weight loss, weakness (e.g., low grip strength), slow walking speed, low physical activity, and/or self-monitoring for exhaustion. Such expertise and resources are often not available in a primary care setting, where primary care practitioners are often non-experts and are not trained to measure or assess clinical metrics such as the Fried frailty index.